The Epidemic of Physician Burnout
Shocking statistics indicate that more than 50 percent of physicians suffer from burnout. (1) Physician burnout significantly reduces the quality of life of physicians and has serious implications for patients. Read on to learn about the causes and consequences of physician burnout and how a collaborative, functional approach to healthcare can help physicians recover from burnout and reclaim their passion for medicine.
What Causes Physician Burnout?
Most people are drawn to the medical field out of an intense desire to help others and make the world a better place. Unfortunately, the fresh-faced enthusiasm of the young medical student may be a short-lived phenomenon in our modern-day healthcare system. Statistics indicate that physician burnout, a condition characterized by emotional exhaustion, cynicism, and inefficiency, has dramatically escalated in recent years. Between 2011 and 2014, the number of U.S. physicians with burnout rose from 45 percent to over 50 percent. (2) What is responsible for this striking increase in physician burnout? Research indicates that burnout is a multifactorial problem stemming from physicians’ high patient volume, financial pressure, extremely long work hours and poor work–life balance, inefficiencies posed by the electronic medical record system, and the increasingly litigious work environment that has become characteristic of our modern medical system.
Patient Volume
Physicians often see upwards of 25 patients per day. The sheer volume of patients means that doctor–patient interactions are often limited to a mere 15 minutes. This leaves little time for doctors to get to know their patients and identify the underlying causes of disease. Unfortunately, the quickest solution is simply to write out a prescription. This model of healthcare shortchanges patients, preventing them from getting the care they need and deserve. This problem has not gone unnoticed by doctors and has left many of them feeling disillusioned and helpless about their ability to truly help their patients.
The enthusiasm of medical students is a short-lived phenomenon in modern-day healthcare and statistics show physical burnout is on the rise.
Financial Pressure
Forty percent of medical school grads owe more than $200,000 in student debt. This financial burden has helped to shape our current “factory” model of healthcare, in which physicians must see a certain number of patients per day in order to earn sufficient money to pay off student debt. While this medical model may alleviate physicians’ financial burden, it decreases the amount of time physicians can spend with their patients and lowers the quality of patient care.
Long Hours
People who enter the medical profession are not afraid of hard work, but the current number of hours most physicians work—60 to 70 hours per week—is enough to wear down even the most dedicated, resilient individual. The long work hours required of physicians disrupt their work–life balance, preventing them from spending time with their families and engaging in restorative pastimes and self-care practices.
The Electronic Medical Record
The electronic medical record (EMR), a systematized collection of digitally stored patient health information, has been singled out as one of the most important drivers of physician burnout. (3) Research indicates that approximately six hours of a physician’s eleven-hour day is spent laboriously entering information into electronic medical records (EMRs). (4) Keeping up with time-intensive EMRs and other data entry tasks is a constant struggle for physicians and eats up time that could be spent with patients. This is not to say that there isn’t a place for EMRs in medical practice; when designed properly, they can have a positive impact on patient care. Unfortunately, most EMRs are bloated and inefficient and end up decreasing—rather than increasing—the quality of care.
Litigious Environment
Our current healthcare system is an extremely litigious environment that has led many physicians to practice “liability/defensive medicine.” In liability/defensive medicine, doctors are order unnecessary tests and procedures to protect themselves from potential malpractice suits. This has significant financial consequences. In fact, it is estimated that the United States spends $46 billion annually on unnecessary tests and procedures that qualify as liability/defensive medicine. (5)
The Costs and Consequences of Physician Burnout
The implications of physician burnout are so significant that the phenomenon has been referred to as a public health crisis. On a personal level, physician burnout is associated with an increased risk of depression, anxiety, sleep disturbances, fatigue, alcohol and drug abuse, and marital dysfunction. Alarmingly, physician burnout has also been linked to suicidal ideations; in 2015, a Mayo Clinic study found that 7 percent of physicians surveyed had considered suicide within the past year and approximately 400 physicians went through with the act. These shocking figures put the serious problem of physician burnout into perspective. (6)
Physician burnout also takes a toll on patients. Physicians who are burned out are more likely to experience decrements in job performance, demonstrate hostility towards patients, and commit medical errors. These consequences lower the quality of patient care and, in the case of medical errors, may even put patients’ lives at risk.
While the consequences of physician burnout are grave, the costs are also no small matter. An initiative undertaken at Stanford University found that physician burnout costs the university $7.75 million a year. (7) Additional research found that it costs $800,000 to $1.3 million to recruit and train a doctor to replace a physician who has resigned due to burnout. (8) Finally, even if a burned-out physician stays in practice, hospitals often rack up costs due to physician inefficiency. Clearly, physician burnout is not only bad for doctors and patients, but also for business.
The Antidote to Burnout: A Collaborative, Functional Healthcare System
Many of the factors that contribute to physician burnout stem from our bureaucratic and impersonal healthcare system. If we want to halt the epidemic of physician burnout, we need to take a revolutionary new approach to healthcare. Fortunately, we have a solution already available in the form of a collaborative, functional healthcare model.
In a collaborative model of healthcare, allied providers, nutritionists, and health coaches work alongside physicians to provide additional layers of support to patients. This streamlines the patient care process, improves the quality of patient care, and creates a better work environment for physicians. The addition of a Functional Medicine approach further strengthens the collaborative model by helping physicians truly heal their patients. Functional Medicine allows physicians to identify and treat the root causes of disease, rather than just covering up symptoms with prescriptions, and therefore to make a lasting positive difference in their patients’ lives. This approach also gives physicians more autonomy, increases their professional satisfaction and quality of life, and results in better outcomes for patients.
Physician burnout is a critical problem with harmful consequences for both physicians and patients. However, by transitioning to a collaborative, functional healthcare model, it is entirely possible for physicians to not only recover from burnout but to fully regain their passion for medicine, achieve a higher quality of life, and make a real difference in their patients’ lives.
Thank you for this and all your teachings. It is not easy to develop abilities to be efficient in the work but, certainly, we can do it and you are a good example. God bless you and your new baby.
Hi Chris,
Your thinking resonates…. There are many who understand and agree with the literature on burnout as well as the need for a change. There’s the rub. How? You intimate a solution but leave readers hanging. Are you insinuating that training through your ADAPT Academy offers the solutions to that collaborative and fulfilling model? (info?, mentoring?) I’d appreciate you expounding on this.
BTW, I own and work at very busy outpatient physical therapy clinic. We’re incredibly busy as we offer the skills and time needed to effectively treat out chronic pain. Perhaps as important, we honor the whole person. We’re not on an assembly line “doing widgets” like so much of the healthcare system. As such, I’d like to expand our healthcare community by hiring or creating an alliance with other like-minded practitioners with the helping hand of some sort of template. Please show your cards.
I so love functional medicine that I have not had insurance for 12 years as I pay to go to a functional medicine doc. I am turning 65 next month and therefore must go on medicare and pay for part B a regular doctor :(. Not that they are not good doctors but for all of the reasons you just mentioned in your article I am not excited about seeing a regular Doc. When one retires they try to cut down on expenses so I would like to see the government include Functional Medicine Doctors in the medicare menu. Have you heard if this subject has ever been approached or considered?
Dear Catherine,
I love your vision on including Functional Medicine in our medicare/global health care/insurance system. I think this is a grass roots effort taking off. Hopefully in our life time (Happy 65th Birthday) your grows.
Running a very busy Chiropractic/Functional Medicine clinic I see the need for this type of patient care expanding. People are demanding more as the population gets better informed.
Thanks for your insightful comments.
Better and Better,
Dr Sue Mullen, DC Berkeley, CA
Dear Catherine,
I love your vision – including Functional Medicine in our medicare/global health care/insurance system. I think this is a grass roots effort taking off. Hopefully in our life time (Happy 65th Birthday)
Running a very busy Chiropractic/Functional Medicine clinic, I see the need for this type of patient care expanding. People are demanding more as the population gets better informed.
Thanks for your insightful comments.
Better and Better,
Dr Sue Mullen, DC Berkeley, CA